关键词: 膝骨关节炎, 2型糖尿病, 加味阳和汤, 塞来昔布, 分泌型糖蛋白-3α, 破骨细胞相关受体, 破骨细胞生成因子, 膝关节功能

Abstract:

Objective To investigate the effects of Jiawei Yanghe Decoction on the levels of serum secretory glycoprotein-3α （Wnt-3α）， osteoclast-related receptor （OSCAR）， receptor activator of NF-κB ligand （RANKL）， and the knee joint function in patients with type 2 diabetes mellitus complicated by knee osteoarthritis. Methods A total of 98 patients with type 2 diabetes mellitus complicated by knee osteoarthritis were randomly divided into a control group （celecoxib + conventional hypoglycemic therapy） and an observation group （celecoxib + conventional hypoglycemic therapy + Jiawei Yanghe Decoction） using the random number table method， with 49 cases in each group. Both groups received treatment for 4 weeks. The clinical efficacy， score of traditional Chinese medicine syndrome， levels of serum Wnt-3α， OSCAR， RNKL， glucose and lipid metabolism indexes， insulin-like growth factor （IGF）， transforming growth factor-β （TGF-β）， 25-hydroxyvitamin D₃ ［25（OH）D₃］， inflammatory factors， pain， and knee joint function were compared between the two groups. Results After 4 weeks of treatment， the total effective rate of the observation group was significantly higher than that of the control group （P 0.05）. Moreover， after 4 weeks of treatment， the scores of joint pain， pain fixation， swelling， limited joint activity， aversion to wind and cold， preference for joint warmth and stimulation， as well as the levels of serum Wnt-3α， RNKL， fasting blood glucose （FPG）， glycosylated hemoglobin （HbA_1c）， triglyceride （TG）， total cholesterol （TC）， IGF， interleukin-1 （IL-1）， interleukin-6 （IL-6）， scores of visual analogue scale （VAS）， and Western Ontario and McMaster University Osteoarthritis Index （WOMAC） in both groups were lower compared to those before treatment. Notably， the values in the observation group were significantly lower than those in the control group （P 0.05）. In addition， the levels of serum OSCAR， TGF-β， and 25（OH）D₃ were higher than those before treatment， and the levels in the observation group were significantly higher than those in the control group （P 0.05）. Conclusions Jiawei Yanghe decoction， in combination with celecoxib and routine hypoglycemic therapy， can effectively enhance the traditional Chinese medicine syndrome score of patients with type 2 diabetes mellitus complicated by knee osteoarthritis. It can also regulate the serum levels of Wnt-3α， OSCAR， RNKL， IGF， TGF-β， and 25（OH）D₃， reduce the inflammatory response， alleviate pain， and improve the body's glucose and lipid metabolism as well as knee joint function， demonstrating good clinical efficacy.

Key words: knee osteoarthritis, type 2 diabetes, Jiawei Yanghe decoction, celecoxib, secretory glycoprotein-3α, osteoclast-related receptor, receptoracti-vatorofnf-kbligand, knee joint function